Coronary heart disease

Heart disease, Coronary heart disease, Coronary artery disease; Arteriosclerotic heart disease; CHD; CAD

Coronary heart disease is a narrowing of the small blood vessels that supply blood and oxygen to the heart. Coronary heart disease (CHD) is also called coronary artery disease.

Coronary artery disease (CAD) overview

Coronary Artery Disease (CAD) includes diseases of the arteries that supply the heart muscle with blood. It is responsible for more than half of all cardiovascular events in men and women under the age of 75 years. CAD, which is sometimes called coronary heart disease or ischemic heart disease, is most often caused by atherosclerosis. Atherosclerotic plaque forms when cholesterol and other fatty material are deposited within the arterial wall. Plaque deposits narrow the coronary arteries that supply the heart, thereby reducing blood flow to the heart muscle. If plaque ruptures, it can trigger the formation of a blood clot and completely obstructs the flow of blood to the heart. CAD also has many non-atherosclerotic causes, including genetic abnormalities of the coronary vessels, systemic vasculitis, and radiation-induced coronary disease. When coronary arteries are narrowed or blocked, oxygen-rich blood cannot reach the heart muscle, resulting in chest pain, also called angina or myocardial infarction. Over time, CAD may weaken the heart muscle and lead to serious pumping problems and abnormal heart rhythms. Therapeutic approaches for CAD include the use of 3 strategies: First, treatment to reduce the heart’s workload Second, improving coronary artery blood flow Third, slowing down or reversing the build-up of atherosclerotic plaques. The heart’s workload can be reduced by controlling the BP and using drugs such as beta blockers or calcium-channel blockers that keep the heart from pumping as hard. Coronary blood flow can be improved by surgical procedures such as a percutaneous coronary intervention or coronary artery bypass grafting. A coronary artery thrombus may sometimes be dissolved by drugs, also improving coronary circulation. Modifying the diet, exercising regularly, and appropriate pharmacological therapy can slow down or help reverse atherosclerosis.

Heart - section through the middle

The interior of the heart is composed of valves, chambers, and associated vessels.

Heart - front view

The external structures of the heart include the ventricles, atria, arteries and veins. Arteries carry blood away from the heart while veins carry blood into the heart. The vessels colored blue indicate the transport of blood with relatively low content of oxygen and high content of carbon dioxide. The vessels colored red indicate the transport of blood with relatively high content of oxygen and low content of carbon dioxide.

Anterior heart arteries

The coronary arteries supply blood to the heart muscle. The right coronary artery supplies both the left and the right heart; the left coronary artery supplies the left heart.

Posterior heart arteries

The coronary arteries supply blood to the heart muscle. The right coronary artery supplies both the left and the right heart; the left coronary artery supplies the left heart.

Chest pain

When people have chest pain, they're often concerned they're having a heart attack. I'm Dr. Alan Greene and I'd like to talk to you for a moment about the different kinds of chest pain and when it may be an emergency. It turns out, there are lots of different kinds of chest pain. In fact, almost everything in the chest can hurt in one way or another. Some of the causes are really nothing more than a minor inconvenience. Some of them though are quite serious, even life threatening. You can have chest pain sure from the heart, but also from pneumonia. You can have chest pain from asthma. You can have chest pain from a blood clot in the lungs. It can be from nothing more than a strain of some of the muscles between the ribs, or nerves. You can also have chest pain that comes from acid reflux of from a stomach ulcer, gallstones. Many, many things can cause chest pain. You want to call 911 if you are having sudden, crushing chest pain or if your chest pain radiates into the jaw or the left arm. You want to call 911 if your chest pain also causes shortness of breath, or dizziness, nausea, or vomiting. You want to call 911 if you know you have heart disease and you do occasionally have pain but your pain is getting significantly worse than it is ordinarily. Or comes on with less activity than it does otherwise. But whatever the cause of chest pain, unless you're sure what's causing it, it's worth contacting your physician to find out what may be going on. It's not a symptom to ignore.

Acute MI

A heart attack or acute myocardial infarction (MI) occurs when one of the arteries that supplies the heart muscle becomes blocked. Blockage may be caused by spasm of the artery or by atherosclerosis with acute clot formation. The blockage results in damaged tissue and a permanent loss of contraction of this portion of the heart muscle.

Cholesterol producers

Cholesterol is a waxy, fat-like material that is found in all parts of the body. It comes from two sources: our liver produces it, and we consume it in animal products.

Angina causes and symptoms

Angina, or angina pectoris, is temporary chest pain or a sensation of pressure that occurs when the heart’s need for oxygen is not satisfied by the amount of blood supplied to the heart. Blood flow can be limited when the arteries are narrowed by atherosclerosis, or because of coronary artery spasms. Symptoms of angina may also include discomfort in the shoulders, inside the arms, through the back and in the throat, jaw, or teeth. Angina due to atherosclerosis usually occurs during physical exertion or emotional distress, or at rest if the artery is narrowed by more than 70%.


Atherosclerosis is a disease of the arteries in which fatty material is deposited in the vessel wall, resulting in narrowing and eventual impairment of blood flow. Severely restricted blood flow in the arteries to the heart muscle leads to symptoms such as chest pain. Atherosclerosis shows no symptoms until a complication occurs.

A look at coronary artery disease (CAD) including causes, symptoms, health risks, and treatment.



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Outlook (Prognosis)

When to Contact a Medical Professional